Americans’ use of supplements, prescriptions and over the counter (OTC) medications has been steadily increasing over the past couple of years. This increase can sometimes put patients at risk for complications and interactions. Believe it or not, a lot of over-the-counter medications can actually interact with your prescription medications (and affect how they work) without you even realizing it. Understanding how OTC medications, vitamins, supplements and prescriptions medications interact is important for your health and safety.

First off what is an OTC medication?

An over the counter medication, according to the Food and Drug Administration (FDA), is a medicine that you can buy without a prescription. These medications are considered safe and effective when you follow the directions on the label, or as directed by your health care professional.

The beauty of OTC medications is the convenience and ability, as a patient, to select a medication for your specific symptoms without a trip to the doctor. However, if you take any prescription medications, it is always recommended to check with your doctor or pharmacist before perusing the OTC aisles to ensure that it wont interact with any prescription medications.

What about vitamins, minerals, supplements?

Many people consider vitamins, minerals and supplements as “natural,” thinking that they won’t cause any problems or interactions. It may come as a surprise to some, but just like other OTC medications, vitamins, minerals and supplements can also interact with prescription medications.

It is important to understand the risks associated with the use of OTC medications, including those that give the illusion that they are natural or safe.

What are some common OTC and prescription drug interactions that I should know of?

Blood Thinners like Coumadin (warfarin), Pradaxa, Eliquis, Xarelto and Plavix can interact with the following and cause an increased risk of bleeding:

Birth control like LoesterinFe, Ortho-TriCyclen, Seasonale and Yaz can become less effective in combination with St. John’s Wart. In fact, mixing these two products could lead to possible pregnancy

SSRI Antidepressant Medications like Celexa, Lexapro and Prozac also interact with St. John’s Wort. Mixing these could increase your risk for serotonin syndrome, which can cause symptoms like diarrhea, seizures or even death.

MAOI antidepressants like Parnate, Nardil and Marplan interact with the following and can also increase your risk for serotonin syndrome.

Robitussin DM

Mucinex DM

Nyquil Cold & Flu

Coricidin HBP Products

Pain Medications like Norco, Vicodin, Percocet, Tylenol with Codeine and Ultracet don’t mix well with other products containing Tylenol, like Tylenol PM, Nyquil, Dayquil, and Mucinex. The maximum daily amount of Tylenol (acetaminophen) is now 3,000 mg per day, so mixing pain medications that contain acetaminophen with other Tylenol products can mean that you are taking more than the recommended amount of Tylenol without realizing it.

These are just a few of the common interactions between prescription and OTC medications! Remember, if you are concerned about any interactions between your medications, you can always check with your doctor or pharmacist.

About The GoodRx Medical Team

Dr. Sharon Orrange, MD MPH

Dr. Orrange is a Clinical Associate Professor of Medicine at the University of Southern California, as well as a practicing adult medicine doctor in Los Angeles. She also has a Masters in Public Health from Johns Hopkins University. She does not receive any form of compensation from pharmaceutical manufacturers for the opinions expressed here. Follow her on twitter at @orrangemd.

The GoodRx Pharmacist

Roni Shye, PharmD CGP BCACP graduated from Duquesne University and is a licensed pharmacist in the states of Florida, Ohio, and Pennsylvania. Her realm of pharmacy experience includes but is not limited to retail, compounding, and specialty pharmacy. Currently she is a mentor for Strong Women Strong Girls, certified thru APhA in Medication Therapy Management and diabetes, and an active member of The Ohio pharmacists association, LGBT, and the Women's Business Resource Group.

Elizabeth Davis

Elizabeth Davis is GoodRx's medical editor and consumer savings expert. She hand-assembled the GoodRx drug database and has researched virtually every available discount program and savings opportunity.

Disclaimer: The content posted here is for informational purposes only and is not intended as a substitute for medical advice, diagnosis or treatment. GoodRx does not recommend or endorse any specific prescription drug, pharmacy or other information. We urge you to talk to your doctor before starting, changing or terminating any medical treatment.

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